INTRODUCTION

URINARY SYSTEM
INTRODUCTION
 KIDNEY
 PRIMARY FUNCTION
1. CLEAR WASTE PRODUCTS
2. REABSORPTION OF NUTRIENTS
 CONTAINS APPROXIMATELY 1
TO 1.5 MILLION NEPHRONS.
RENAL FUNCTION
 RENAL BLOOD FLOW
 GLOMERULAR FILTRATION
 TUBULAR REABSORPTION
 TUBULAR SECRETION
RENAL
FUNCTION

 Renal
Blood
Flow
RENAL
FUNCTION

Glomerular
Filtration
GLOMERULAR FILTRATION
 FILTRATION PROCESS INCLUDE:
 CELLULAR STRUCTURE OF THE GLOMERULUS
 HYDROSTATIC AND ONCOTIC PRESSURES
 RENIN-ANGIOTENSIN-ALDOSTERONE SYSTEM
CELLULAR STRUCTURE OF THE GLOMERULUS
Hydrostatic and Oncotic pressures
Renin-
Angiotensin-
Aldosterone
System
• MUST TO KNOW ABOUT GLOMERULAR FILTRATION:
1.EVERY MINUTE APPROXIMATELY TWO TO THREE MILLION
GLOMERULI FILTER PASSES THE GLOMERULUS.
2.THIS FILTRATION IS NONSELECTIVE AND CAN BE
DIFFERENTIATED TO PLASMA BY THE ABSENCE OF
THE PLASMA PROTEINS
3.ANALYSIS OF THE FLUID AS IT LEAVES THE
GLOMERULUS SHOWS THE FILTRATE TO HAVE A SPECIFIC
GRAVITY OF
1.010 AND CONFIRMS AS AN ULTRAFILTRATE OF PLASMA.
 Tubular
Reabsorption
Tubular Reabsorption
 REABSORPTION MECHANISMS
 TUBULAR CONCENTRATION
 COLLECTING DUCT CONCENTRATION
Reabsorption mechanisms
 Reabsorption mechanisms
 ACTIVE TRANSPORT, LIKE PASSIVE TRANSPORT, CAN BE
INFLUENCED BY THE CONCENTRATION OF THE SUBSTANCE BEING
TRANSPORTED.
 (TM) - MAXIMAL REABSORPTIVE CAPACITY
 THE PLASMA CONCENTRATION AT WHICH ACTIVE TRANSPORT
STOPS IS TERMED THE RENAL THRESHOLD.
 KNOWLEDGE OF THE RENAL THRESHOLD AND THE PLASMA
CONCENTRATION CAN BE USED TO DISTINGUISH BETWEEN EXCESS
SOLUTE FILTRATION AND RENAL TUBULAR DAMAGE.
 Tubular Concentration

 DLH AND ALH IS THE BEGINNING OF

RENAL CONCENTRATION BECAUSE THE
FILTRATE IS EXPOSED TO THE HIGH
OSMOTIC GRADIENT OF THE RENAL
MEDULLA.
 WATER IS REMOVED BY OSMOSIS IN
THE DESCENDING LOOP OF HENLE.
 SODIUM AND CHLORIDE ARE
REABSORBED IN THE ASCENDING LOOP.
Tubular Secretion
 INVOLVES THE PASSAGE OF
SUBSTANCES FROM THE BLOOD IN
THE PERITUBULAR CAPILLARIES TO
THE TUBULAR FILTRATE.
 2 MAJOR FUNCTIONS:
 ELIMINATING WASTE PRODUCTS NOT
FILTERED BY THE GLOMERULUS.
 REGULATE ACID–BASE BALANCE.
Tubular Secretion
 ACID BASE BALANCE
 IMPORTANT TO MAINTAIN BLOOD PH.
 BLOOD MUST BUFFER AND ELIMINATE THE EXCESS
ACID FORMED BY DIETARY INTAKE AND BODY
METABOLISM.
 THE BUFFERING CAPACITY OF THE BLOOD DEPENDS
ON BICARBONATE.
 100% REABSORPTION OF fiLTERED BICARBONATE AND
OCCURS PRIMARILY IN THE PROXIMAL CONVOLUTED
TUBULE.
 HYDROGEN IONS ARE READILY fiLTERED AND REABSORBED.
INTRODUCTION TO URINALYSIS
HISTORY
HISTORY
HISTORY

“ PISSE PROPHETS ”
- THOMAS BRYANT (1627)
HISTORY
URINE
 FACTORS THAT AFFECT
URINE CONCENTRATION

1. DIETARY INTAKE
2. , PHYSICAL ACTIVITY,
3. BODY METABOLISM,
4. ENDOCRINE FUNCTIONS.
URINE
COMPOSITION

95% water
5% solutes
URINE VOLUME
• NORMAL DAILY URINE OUTPUT IS USUALLY 1200 TO 1500 ML.
• A RANGE OF 600 TO 2000 ML IS CONSIDERED NORMAL.
 ABNORMAL URINE VOLUME
OLIGURIA ANURIA POLYURIA
- DECREASE IN URINE - CESSATION OF - INCREASE IN
OUTPUT URINE DAILY URINE
< 1ML/KG/HR : INFANTS SERIOUS DAMAGE TO THE
KIDNEYS OR
VOLUME
<0.5ML/KG/HR : CHILDREN
DECREASE IN THE FLOW OF BLOOD > 2.5L/DAY : ADULTS
<400ML/DAY : ADULTS TO THE KIDNEYS.
> 2-3ML/KG/DAY :
CHILDREN
SPECIMEN COLLECTION
SPECIMEN INTEGRITY
SPECIMEN
TYPES
END